The elbow joint consists of the humerus (upper arm), ulna (forearm bone) and the radius (forearm bone). The three bones come together to form the articulating surfaces of the elbow joint.
There are four basic movements performed by the elbow joint; flexion (bending), extension (straightening), pronation (turning palm of hand downward) and supination (turning palm upward).
Range of motion exercises typically address all four aspects of motion.
Active Flexion
Active flexion, or bending, of the elbow occurs from the contraction of the bicep muscles forcing the hand to move closer to the front portion of the upper arm, or humerus. The typical range of motion for the elbow is zero to 145 degrees.
Exercises utilizing active flexion can be performed using free weights such as dumbbells, therapeutic bands of various tensile strength or no weight at all. These exercises typically begin with the elbow in full extension (fully straight) and flexion is activated to the desired degree and amount.
Passive flexion
Passive flexion is the motion of bending the elbow without any personal involvement by the one exercising. This motion is typically instituted by an external partner or professional physical therapist. Passive flexion is used in instances of injury to muscles or bone(s) where joint motion needs to be preserved, without active muscle involvement.
Passive extension
Passive extension, like flexion, is usually performed by someone other than the subject in question, thus eliminating any active participation by the subject's own muscles.
Reasons for this type of range of motion is often used to exercise the joint to accommodate an ultimate extension of zero degrees, or fully straight. Trauma to the elbow, forearm or upper arm can contribute to scar formation or stiffening of soft tissues, making it difficult to extend the arm fully.
Passive extension allows for an outside person to exert more gentle pressure to the elbow than the subject would/could allow on his/her own because of deterrents such a pain and apprehension.
Active extension
Active extension involves the activation of the subject's triceps muscles at the rear of the upper arm. The goal is to achieve zero degrees of extension, which means the arm is completely straight.
Pronation
Pronation of the forearm, or turning the palm of the hand over and downward, actually starts with the palm of the hand facing upward. The range of pronation is considered full when the palm faces completely downward.
Pronation, like supination (turning the palm upward), while considered a forearm motion, is determined by the health of the joint surfaces between the radial head and the distal humerus bones that are key components of the elbow.
Pronation exercises can be performed either in an active (by the subject) or passive manner (performed by another without physical input from the subject), depending on the desired outcome and state of the subject and his elbow joint at the time.
Fracture of the radial head (that portion of the radius forearm bone that meets with the humerus at the elbow) is a common injury that can restrict pronation due to pain and scar formation.
Supination
Range of motion for supination of the forearm is zero to 85 degrees, and begins when the palm is faced down. Measurements are taken as the palm of the hand turns upward to just slightly less then 90 degrees, which is considered full supination.
These exercises are typically performed either in a passive state or with varying degrees of resistance, depending upon the goals of the exercises.
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